• Soo Hyun Kim, Jeong Hoon Yeon, Kyu Nam Park, Sang Hoon Oh, Seung Pill Choi, Young Min Kim, Han Joon Kim, and Chun Song Youn.
• Department of Emergency Medicine, Seoul St. Mary's Hospital, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Republic of Korea.
• Scand J Trauma Resus. 2016 Jun 6; 24: 81.

BackgroundThe objective of the study was to test the hypothesis that elevated red cell distribution width (RDW) at admission increases the risk of mortality in older patients admitted to the emergency department (ED).MethodsWe performed a retrospective analysis of patients admitted to the ED between May 2013 and October 2013. We included patients who were older than 65 years who visited the ED with any medical problems. Baseline RDW values were measured at the time of admission to the ED. The primary outcome was all-cause in-hospital mortality. Multivariate logistic analysis was performed.ResultsA total of 1,990 patients were finally included in this study. The mean age was 75 years (SD 7), and 936 (47 %) subjects were male. The in-hospital mortality rate was 3.76 % (74 patients). RDW values higher in non-survivors than in survivors (15.9 ± 2.5 vs. 13.8 ± 1.7, p < 0.001). Multivariate logistic analysis showed that RDW was associated with all-cause in-hospital mortality after adjusting for other confounding factors.DiscussionRDW value at admission is an independent predictor of all-cause in-hospital mortality among patients older than 65 years. After adjustment for multiple confounders, the all-cause in-hospital mortality rate increased by 21.8% for each 1% increase in RDW.ConclusionThese results show that RDW at admission is associated with in-hospital mortality among patients older than 65. Thus, RDW at admission may represent a surrogate marker of disease severity. We caution against using these findings to aid clinical decision-making process until they are externally validated.

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